Article, see p 2009

The use of risk adjustment methods to assess the safety of procedures for congenital heart disease began 15 years ago.^1,2 It is a good thing. Like many cardiologists and surgeons, I do not develop the tools, and I have never learned any of the arcana of methods and statistics used to develop those tools. However, I have relied on and continue to use them as an integral part of understanding the performance of an individual, program, or field. The current article by Jayaram et al³ in Circulation improves our understanding of the risks of catheterization for congenital heart disease, extending prior work⁴ to the many more patients and centers in the IMPACT Registry (Improving Pediatric and Adult Congenital Treatments). This article is a welcome addition to the field.

Given this work, a consumer should perhaps be thinking about 3 questions. What are the probable weaknesses of all such tools? What are the weaknesses specific to this one? How …

文章，请参阅第2009页

风险调整方法用于评估先天性心脏病手术安全性的方法始于15年前。^1，2，是一件好事。像许多心脏病专家和外科医生一样，我没有开发工具，而且我从未学习过用于开发这些工具的任何方法和统计学的奥秘。但是，我依靠并继续将它们用作理解个人，程序或领域的性能的组成部分。Jayaram等人在《循环》杂志上发表的最新文章³增进了我们对先天性心脏病导管插入术风险的理解，扩展了先前的工作⁴到IMPACT注册中心的更多患者和中心（改善儿科和成人先天性治疗）。本文是对该领域的欢迎补充。

鉴于这项工作，消费者可能应该考虑三个问题。所有这些工具可能存在哪些弱点？此功能有哪些弱点？如何 …